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Abstract

This study aimed to investigate the effect of short-term intracanal application of calcium hydroxide on the apical leakage of root fillings with an apical barrier. Root canals of 288 extracted intact, single-rooted teeth were prepared up to #90 using K-type files in conjunction with 2,5 % NaOCl irrigation between each file size. In each root, a divergent open apex was simulated by retrograde apical preparation with a #30 rotary files. Following sectioning of crowns and adjusting root length to 12 mm, half of the roots (n=144) were filled with a calcium hydroxide paste (experimental group) using a lentulo spiral in a low-speed handpiece. The teeth were kept in moist gauze for 30 days. The teeth in experimental group were further assigned into two subgroups. The teeth in first subgroup (n=72) were irrigated with 2,5% NaOCl without mechanic agitation, while in the second subgroup (n=72), the root canals were rinsed with 2,5% NaOCl using passive ultrasonic irrigation. Thereafter, a 4mm apical barrier of mineral trioxide aggregate (MTA) was placed into the canals. Each subgroup was further divided to three groups: where 24 specimens were filled with Gutta-Percha/AH Plus, 24 specimens with Resilon/Epiphany and in 24 specimens being left empty. The specimens in control group were prepared by repeating the same procedures in experimental group. Apical parts of the roots were subjected to fluid filtration and apical microleakage values were determined after 24 hours and 30 days. Statistical analysis of experimenal data was made using Wilcoxon Signed Ranks Test and Conover's Multiple Comparison Test with Bonferroni correction. The control group showed better sealing properties than the experimental group (p<0,001). Likewise, passive ultrasonic irrigation group resulted in better sealing performance (p<0,001). Compared with ProRoot MTA, MTA Angelus apical barriers showed significantly greater apical leakage (p<0,001). In both the experimental and control groups, there was no significant difference between the apical leakage of gutta-percha and Resilon groups (p>0,0031), irrespective of the type of irrigation protocol or apical barrier. However, when MTA Angelus was used as an apical barrier after ultrasonic irrigation, roots filled with gutta-percha showed significantly greater apical leakage in compared to those filed with Resilon (p<0,0031).